All children referred to the Morgan Stanley Children's Hospital of New York Presbyterian (MSCHONY) with malignancy are considered for participation in clinical research trials based on protocol eligibility criteria. Columbia University is a full member of the NCI-funded Children's Oncology Group (COG), which provides Phase II and Phase III trials. Furthermore, Columbia University is one of 21 approved COG Phase I programs. For pediatric leukemia and lymphoma, the program offers studies from the Dana-Farber Cancer Institute (DFCI) and Therapeutic Advances in Childhood Leukemia (TACL) consortia and hosts industry sponsored and investigator initiated studies. In addition, a number of active investigator and pharmaceutical initiated clinical oncology trials for other diseases are open. A broad spectrum of active clinical studies is available for participation of children diagnosed with cancer. MSCHONY is one of only two university-affiliated hospitals dedicated exclusively to children in the greater New York metropolitan region. More importantly, it is the only children's hospital in the NY metropolitan area that is part of an NCI-designated Comprehensive Cancer Center. The dedicated inpatient oncology and transplant unit weekly census averages 20-25 patients. Outpatient facilities for pediatric oncology are located in the Herbert Irving Pavilion and are part of the Herbert Irving Cancer Center. The unit consists of nine exams rooms, two of which are isolation rooms and one is a positive pressure room. The infusion area has 16 stations for administration of outpatient chemotherapy and transfusions. The Herbert Irving Division of Pediatric Hematology/Oncology/Stem Cell Transplantation incorporates a primary focus on the care of children with a wide variety of malignant disorders. The division maintains a network of affiliated institutions that includes Stamford Hospital In Stamford, Connecticut and Lincoln Hospital and Harlem Hospital that are part of the New York City Health and Hospitals Corporation. The members of the division include seventeen full time physicians, nine pediatric hematology/oncology fellows, two psychologists, five primary research faculty and more than 80 additional health care professionals engaged in the activities of the division such as research, administration, patient care services and education. In 2012, Andrew Kung, MD PhD became division director. Under Dr. Kung's leadership, enhanced translational oncology research will integrate genomics into the clinical trial setting. The number of new oncology patients referred averages between 120 and 140 per year and admissions were over 550 in 2012. Outpatient visits now exceed 7500 visits per year. In 2012, the division was the highest enrolling COG institution in the New York metropolitan area, with 32 therapeutic and 92 non-therapeutic enrollments. Dr. Alice Lee serves as the institutional principal investigator for COG. The infrastructure includes two Research Nurse Practitioners, a Regulatory Affairs Coordinator and two Clinical Research/Data Coordinators. In 2012, the new CUMC Minority Based CCOP Incorporates the institution's participation In the COG therapeutic and cancer control phase II and III trials. Dr. Kara Kelly is the PI for the MBCCOP grant, thus demonstrating the significant role that pediatrics has in the conduct of the MBCCOP. This mechanism will help support additional recruitment of children to pediatric trials, especially the significant minority population that is treated at our center. Dr. Julia Glade Bender directs our pediatric developmental therapeutics program. Ours is one of the founding COG Phase 1 programs designated by the NCI, maintaining its status through two grant cycles, and is the only such program in the New York tri-state area. The program's infrastructure consists of a Director of Research, Clinical Research Nurse Practitioner, Clinical Research/Data Coordinator and a Regulatory Affairs Coordinator. This experienced clinical trials team manages 20 - 24 active phase 1 trials and five phase 2 trials, and has enrolled 87 patients In th6 last five years. In 2012 more than 30 patients with recurrent or refractory cancer were referred from outside institutions for consideration for early phase clinical trials. This well-established program will serve as home to the new Precision in Pediatrics (PIPseq) Cancer initiative aimed at implementing comprehensive sequencing into standard practice for all children and adolescents with cancer.